Participant Information
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Participant Email
Parent/Gaurdian Email
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Have you been part of a skate team?

Release/ Indemnification Agreement:

I am aware that this activity can be a potentially hazardous activity. Before engaging in any physical activity of this nature, I know I should consult with my physician. I should not enter this event unless I am physically able and trained.  I assume all risks associated with the Skateboard Competition, including but not limited to falls, weather conditions, contact with other participants, the effects of the Skate Park and other course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, I, for myself and anyone entitled to act on my behalf, waive and release DMC Companies Inc. T/A the Fairfax Surf Shop and the City of Fairfax plus all event partners, sponsors and volunteers, their employees, agents, representatives and successors (collectively “the Sponsors”), from all claims and liabilities of any kind arising out my participation in this skateboard competition.

I further agree to abide by all rules and regulations of Van Dyck Skate Park as well as the rules and regulations of the competition and the decisions of any event officials.

By signing this release I agree to be bound by and responsible for all the provisions of this release/ indemnification agreement, on behalf of ourselves, the Participant and the successors, representatives, heirs, executors, assigns and transferees of ourselves and the Participants.  We consent to the Participant’s execution of this release and indemnification agreement and participation in the Skateboard Competition.

Electronic Signature Required
Parent/Gaurdian Name: Date: I ACCEPT
Participant Name: Date: I ACCEPT

Skateboard Competition Registration Form

$15 Registration Fee (includes FREE T-shirt!)